Can I Eat as Many Sugar-Free Foods as I Want?

You might be surprised to learn that "sugar-free" does not necessarily mean carbohydrate-free or calorie-free. Although some sugar substitutes do not add calories or carbohydrate, many do. And it is the carbohydrate that has the greatest effect on blood glucose.

People with diabetes do not manage their condition by cutting "sugary" foods out of their diet. If you have diabetes, you can eat sugar-containing foods as part of your overall meal plan, as long as you account for the carbohydrate and calories in the food as part of your overall meal plan. Similarly, if you eat lots of so-called "sugar-free" foods, they may have replaced sucrose (sugar) with sweet tasting substances like sorbitol, mannitol, xylitol, isomalt, and hydrogenated starch hydrolysates. These are all "sugar alcohols," which are technically not "sugar" but are high in carbohydrate. Others may be sweetened with fructose, polydextrose, and maltodextrin, which also contain calories and carbohydrate. These foods will affect your blood glucose just as a sugar-containing food would, in proportion to the grams of carbohydrate in each serving of the food. In addition, foods containing these sugar alcohols can cause stomach discomfort and diarrhea if eaten in large quantities.

Other foods may be sweetened with aspartame or other non-caloric sweeteners like saccharin, acesulfame potassium, or sucralose. These sweeteners contain no carbohydrate. But again, you need to check the food label to see how many grams of carbohydrate are in each serving, because "sugar-free" does not mean "carbohydrate-free." Some of the foods sweetened with non-caloric sweeteners (like aspartame-sweetened sodas) may indeed have no carbohydrate, and will have no effect on your blood glucose. Others, like an aspartame-sweetened yogurt, still contain carbohydrate (from the fruit or milk products in the yogurt) which must be calculated in your meal plan. These foods contain caloric sweeteners in combination with non-caloric sweeteners.

Work with your dietitian and healthcare team to learn how much of different types of foods you can eat at each meal and snack. Very likely your healthcare team will offer you the opportunity to use carbohydrate counting as a way to use meal planning to manage your blood glucose. In carbohydrate counting, you learn how many grams of carbohydrate you should aim for at each meal and snack. Then you read food labels and use carbohydrate gram counting food lists to figure out how you can "spend" the grams of carbohydrate allocated for a particular meal. You devise your meals based on how many grams of carbohydrate you can eat and how many grams of carbohydrate are in the various foods that comprise a given meal.